The COVID-19 Pandemic Crisis and Patient Safety Culture: A Mixed-Method Study

The COVID-19 pandemic has put inordinate pressure on frontline healthcare workers (HCWs) and hospitals. HCWs are under chronic emotional stress, affected by burnout, moral distress and interpersonal issues with peers or supervisors during the pandemic. All of these can lead to lower levels of patient safety. The goal of this study was to examine patient safety culture values in a COVID-19 frontline hospital. Patient safety represents action, while patient safety culture represents the beliefs, values and norms of an organization that support and promote patient safety. Patient safety culture is a prerequisite for patient safety. A cross-sectional study on healthcare workers (228, response rate of 81.43%) at a COVID-19 frontline hospital was conducted using the Hospital Survey on Patient Safety Culture (HOSPSC), which had PSC dimensions, single question dimensions and comments. Our research revealed that, during the COVID-19 pandemic, a number of patient safety issues have been identified: low communication openness and current punitive response to errors, which might have incapacitated HCWs in the reporting of adverse events. Although participants expressed high supervisor/management expectations, actual support from the supervisor/management tier was low. Poor teamwork across units was identified as another issue, as well as low staffing. The infrastructure was identified as a potential new PSC dimension. There was a lack of support from supervisors/managers, while HCWs need their supervisors to be available; to be visible on the front line and to create an environment of trust, psychological safety and empowerment.